HIV暴露儿童血清逆转影响因素分析  

Analysis of the influencing factors on serum reversal in HIV-exposed children

作　　者：李晓玲 吴晓东[2] 袁冬妹 黄婷[1] 刘晓宁[3] 夏俊霞 李莎茜[1] 黄海英 何云[3] LI Xiaoling;WU Xiaodong;YUAN Dongmei;HUANG Ting;LIU Xiaoning;XIA Junxia;LI Shaqian;HUANG Haiying;HE Yun(Department of Preventive Health and Nosocomial Infection Management,Shenzhen Third People's Hospital,Shenzhen 518112,Guangdong Province,China;Information Section,Shenzhen Third People's Hospital,Shenzhen 518112,Guangdong Province,China;Department of Infection and Immunology,Shenzhen Third People's Hospital,Shenzhen 518112,Guangdong Province,China;Department of Obstetrics,Shenzhen Third People's Hospital,Shenzhen 518112,Guangdong Province,China)

机构地区：[1]深圳市第三人民医院预防保健与医院感染管理部,广东深圳518112 [2]深圳市第三人民医院信息科,广东深圳518112 [3]深圳市第三人民医院感染与免疫科,广东深圳518112 [4]深圳市第三人民医院产科,广东深圳518112

出　　处：《医学新知》2024年第5期516-522,共7页New Medicine

基　　金：深圳市科技创新委员会科技计划资助项目(JCYJ20210324131605015)。

摘　　要：目的研究HIV暴露儿童血清逆转相关影响因素。方法收集2019年1月至2021年12月期间深圳市第三人民医院管理的49例HIV感染孕产妇及所生HIV暴露儿童的一般情况、临床资料及血清结果等。结果49例HIV暴露儿童在出生后48 h、6周、3月龄HIV核酸检测均为阴性。在12、18、21月龄时血清逆转率分别为59.18%、93.87%和100.00%。HIV暴露儿童在12月龄血清是否逆转与母亲分娩方式、抗反转录病毒开始时间、孕期核酸检测结果、CD4^(+)T淋巴细胞计数无关;与HIV暴露儿童的性别、出生胎龄与体重、阻断药物使用种类等也无关。结论未发现12月龄HIV暴露儿童血清逆转的明确影响因素,其3月龄核酸检测与最终血清逆转结果一致性为100%。为尽早排除HIV感染,减少家属顾虑,未来可考虑HIV暴露儿童3月龄前3次核酸阴性结果代替血清逆转。Objective To study the factors influencing serum reversal in HIVexposed children.Methods The general information,clinical data,and serum results of 49 cases of HIV-infected pregnant women and their children exposed to HIV were collected from the Shenzhen Third People's Hospital from January 2019 to December 2021.Results All 49 HIV-exposed children were tested negative for HIV nucleic acid at 48 h,6 weeks,and 3 months of age. The serum reversal rates at 12, 18 and 21 months were 59.18%, 93.87% and 100%, respectively. Whether the serum of HIV-exposed children was reversed at 12 months of age was not related to the maternal delivery, anti-retroviral therapy initiation time, nucleic acid test results, CD4^(+)T lymphocyte count (P>0.05). It was not related to children’s sex, gestational age, birth weight, and the type of blocking drug used (P>0.05). Conclusion No clear influencing factors were found for serum reversal in HIV-exposed 12-month-old children. The consistency between nucleic acid detection and final serum reversal was 100%. In order to exclude the possibility of HIV infection as soon as possible and reduce family concerns, three times of negative nucleic acid results before 3 months of age in HIV-exposed children may be considered as a substitute for serum reversal.

关 键 词：HIV感染孕产妇 HIV暴露儿童 血清逆转 早期诊断 母婴传播 核酸检测 影响因素 

分 类 号：R725.1[医药卫生—儿科]